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A few things you may not have expected in the days before and after birth

By Liz Wilkes, My Midwives

Women have lots of information around what to expect from the birthing process but it tends to make it look like there is a significant amount of blood, gore and carnage - or it is a glorified process where there is little need to discuss some of the things you may see and do.

This article aims to overview a few of the changes that you and your baby may undergo in the last days of pregnancy and first days after birth and to explain which are normal and which may need review.

Mucous, discharge and fluid

In the days (and for some weeks) before your baby is born your vaginal discharge – leucorrhoea – will potentially become more noticeable. This is just ‘more’ of normal discharge, not to be confused with mucous or fluid.

Prior to labour commencing you may have a large mucous plug appear in your underwear, or as you wipe yourself after passing urine. This is sometimes referred to as a ‘show’ and is the plug that sits in your cervix throughout pregnancy. Sometimes it can appear an unusual colour, but if in doubt, call your midwife or obstetrician or hospital for advice. It is normal for this to appear in the week or days before labour or in early labour however some women do not experience this at all.

The other change that may occur is that you may feel a ‘pop’ of your membranes or ‘waters’ breaking or you may start having fluid in your underwear or down your leg. Women will be relieved to know it is not common for it to be a very large amount all at once, whilst out in public, but a large gush of fluid can signal that the sac around the baby has released. It is important to have this checked by your care provider so please be in contact with them if this occurs. They will ask when it occurred, how much fluid there was, whether you have had to wear a pad since (and whether the fluid is still coming), the colour and possibly the smell of the fluid. They will also ask about your babies movements and whether you have felt anything else unusual.

Leaking breasts and colostrum

Colostrum is the first breast milk that a baby receives and is produced from around 24 weeks until about 3 days after your baby is born when you start producing a more mature breast milk. It is often a sticky yellow/clear substance that can leak from your breasts particularly in late pregnancy. It is one of the most important substances and provides amazing antibodies and nutrients for your baby in the early days after birth. Women will produce tiny amounts to larger amounts (i.e. a few drops to many mLs) but it is not super important how much there is prior to birth. After birth your baby will feed and this will assist you to produce more of this amazing liquid gold.

Meconium – baby’s first poos

The substance that a baby first poos is like a black green tar called meconium. It is extremely sticky and can be quite hard to clean off baby in the first few nappies after birth. Generally the baby passes meconium when it is first born for about 2 – 3 days and occasionally it also may pass it during labour and in utero particularly where the baby is born at a later gestation (i.e. after the 40 week mark). In hospital your midwife will demonstrate how best to remove it, and how to make sure that it doesn’t spill through the nappy on to clothes. It does not smell particularly most of the time, but it does make an awful mess.

Clots and bleeding

The hours after birth are quite tiresome around the amount of blood loss you may have. Typically women who have had a vaginal birth are likely to initially bleed more than women who have had a caesarean - but it generally tapers off at about the same rate after the first day or two. Blood loss should not be at more than one maternity pad an hour and whilst there may be some small clots, generally this is something to also speak to a care provider about in case there is an unexpected problem with your bleeding. The best strategy is to use a good maternity pad and change regularly with some form of water bottle or jug to rinse with after you change so that you can really feel like you have washed and cleaned the perineal area well. A couple of showers each day will also help you to feel fresher and manage those first days a little better.